Arthroscopic evaluation and treatment of shoulder instability

The use of the arthroscope for shoulder instability has improved our understanding of normal and pathologic shoulder anatomy. We must emphasize, however, that the majority of shoulder problems can be accurately diagnosed with a thorough history and good physical examination. The arthroscope is helpful, however, to confirm a clinical diagnosis or assist in making a diagnosis in difficult or complex pathologic findings. Further, as our surgical techniques and understanding of shoulder instability improve, more pathologic entities about the shoulder become amenable to arthroscopic surgical procedures. We must emphasize that most of these arthroscopic procedures are technically demanding and significant learning curves exist. These procedures should be undertaken only by physicians who have excellent arthroscopic skills and are comfortable recognizing normal and pathologic arthroscopic anatomy of the shoulder.